Document Detail


Anti-heparin/PF4 complexes by ELISA in patients with disseminated intravascular coagulation.
MedLine Citation:
PMID:  20224256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Heparin-induced thrombocytopenia (HIT) is known to complicate disseminated intravascular coagulation (DIC), but rarely to be complicated by DIC. We measured the titers of anti-PF4/hepatin complex antibodies by ELISA (HIT-Elisa) and examined 4 parameters of coagulation and fibrinolysis [D-dimer, thrombin/antithrombin complex (TAT), plasmin/alpha2-plasmin inhibitor complex (PIC), and antithrombin levels] in 80 patients with DIC diagnosed by a DIC scoring system. Fourteen patients were HIT-Elisa-positive, 11 of whom received heparin. In 3 of these 11 patients, platelet counts were < or =10 x 10(9)/l and/or reduced by more than 50% for 5-10 days after the heparin (2 patients treated with renal replacement therapy for chronic uremia and postoperative renal failure, and 1 with DIC from a solid tumor). The 3 patients had an optical density reading of >1.0 and a high level of IgG for HIT antibodies, and were thus considered to have DIC complicated with HIT (DIC-HIT). The other 8 patients had optical density readings of 0.4-1.0, and it was unclear whether their thrombocytopenia was caused by HIT alone or by sustained DIC. There were no significant differences in platelet counts and the 4 parameters of coagulation and fibrinolysis between the patients with DIC-HIT and DIC patients with a weakly positive result (0.4-1.0). No differences were observed in platelet counts, or levels of D-dimer and antithrombin between HIT-Elisa-positive and -negative DIC patients. However, the HIT-Elisa-negative patients showed significantly higher levels of TAT and PIC, presumably reflecting DIC-related hypercoagulability. In conclusion, DIC patients treated with heparin occasionally showed HIT antibody seroconversion and developed HIT. HIT-Elisa could assist in the diagnosis of HIT.
Authors:
Takefumi Matsuo; Miyako Matsuo; Takaki Sugimoto; Keiko Wanaka
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Publication Detail:
Type:  Journal Article     Date:  2010-03-13
Journal Detail:
Title:  Pathophysiology of haemostasis and thrombosis     Volume:  36     ISSN:  1424-8840     ISO Abbreviation:  Pathophysiol. Haemost. Thromb.     Publication Date:  2007  
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101142710     Medline TA:  Pathophysiol Haemost Thromb     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  305-10     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Hyogo Prefectural Awaji Hospital, Sumoto, Japan. hit-center@mbn.nifty.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antithrombin III
Autoantibodies / blood
Biological Markers / blood*
Blood Coagulation / physiology
Disseminated Intravascular Coagulation* / blood,  complications,  diagnosis
Enzyme-Linked Immunosorbent Assay / methods*
Female
Fibrin Fibrinogen Degradation Products / metabolism
Fibrinolysin / metabolism
Fibrinolysis / physiology
Heparin / blood
Humans
Kidney Failure / blood,  complications
Male
Peptide Hydrolases / blood
Platelet Count
Platelet Factor 4 / blood,  immunology*
Retrospective Studies
Thrombocytopenia* / blood,  complications,  diagnosis
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/antithrombin III-protease complex; 0/fibrin fragment D; 37270-94-3/Platelet Factor 4; 9000-94-6/Antithrombin III; 9005-49-6/Heparin; EC 3.4.-/Peptide Hydrolases; EC 3.4.21.7/Fibrinolysin

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